单例成人肾血管平滑肌腺样瘤诊疗分析

Diagnosis and treatment of renal angiomyoadenomatous tumour in adult:a clinical analysis of one case

目的:分析1例成人肾血管平滑肌腺样瘤的临床表现、影像学和病理学特点,以探讨其诊疗方式及预后。方法:回顾性分析我院2014年8月收治的1例成人肾血管平滑肌腺样瘤患者的临床资料:患者无腰痛、肉眼血尿等特异性临床表现,腹部彩超示左肾下极可见6.3cm×4.9cm液性暗区,双肾平扫CT提示左肾下极有6.0cm类圆形低密度影,边界清,双肾强化CT实质期和排泄期均未见明显强化。术前初步诊断为左肾囊肿,行后腹腔镜下左肾囊肿去顶减压术。结果:术后病理检查诊断为肾血管平滑肌腺样瘤。随访3个月,肿瘤无复发和转移。结论:肾血管平滑肌腺样瘤极其罕见,确诊仅能依靠病理检查;临床上易于其他肾脏良恶性肿瘤混淆;手术切除是目前最为有效的治疗方式,预后较好。

Objective：To observe the clinical, radiological, pathological features of renal angiomyoadenomatous tumour in adult, and discuss its diagnosis, treatment and prognosis. Method： A case of adult renal angiomyoade- nomatous tumour was retrospectively analyzed in combination with the related literatures to analyse its features. The patient didn＇t have flank pain, hematuria and other specific clinical manifestations, but a 6.3 cm×4.9 cm fluid dark space on the low pole of the left kidney was shown by the ultrasound. Also, CT scan showed a 6.0 cm low density quasi-circular masss on the low pole of the left kidney, and the density didn＇t change during the nephro- graphic and delayed phases in contrast-enhanced CT. The preoperative diagnosis was renal cyst, and we conducted the renal cyst decortication by retroperitoneal laparoscopy. Result：Pathological report was renal angiomyoadenoma- tous tumour. The patient was followed up for three months, and no recurrence or metastasis was found. Conclu- sion..Renal angiomyoadenomatous tumour is a rare, recently described neoplasm with a distinctive histological ap- pearance. It＇s difficult to distinguish with other benign or malignant renal tumours. Surgery is the most effective treatment. The prognosis is good.